Acute anterior uveitis (AAU), inflammation of the anterior uveal tract, is the most common extraarticular manifestation in patients (pts) with axial spondyloarthritis (axSpA), reported by up to 40% of pts.1 Uveitis is associated with a significant clinical burden; common symptoms include blurred vision, photophobia and pain.2 Previous studies have shown that anti-TNFs can reduce the incidence of AAU flares in pts with radiographic axSpA (ankylosing spondylitis),3,4,5 but few have focused on pts across the full axSpA spectrum. The aim of the C-VIEW study was to analyze the impact of certolizumab pegol (CZP) treatment on AAU flares in pts with active axSpA (radiographic and non-radiographic) and a recent history of AAU.

Methods: C-VIEW (NCT03020992) is an ongoing multicenter, open-label, phase 4 study. Pts had active axSpA according to the Assessment of SpondyloArthritis international Society (ASAS) classification criteria, a history of recurrent AAU (≥2 AAU flares in total and ≥1 AAU flare in the year prior to study entry), were HLA-B27 positive, and were eligible for anti-TNF treatment (active axSpA, previous failure of ≥2 NSAIDs, biologic naïve or had failed at most one anti-TNF). Pts received CZP 400 mg at Weeks (Wks) 0/2/4, then 200 mg every 2 wks through 96 wks. The primary variable was the incidence of AAU flares compared to historic rates. A pre-specified interim analysis compared AAU incidence in the 48 wks prior to CZP treatment initiation with the 48 wks of treatment, using Poisson regression adjusted for possible within-patient correlations, with period (pre- and post-baseline) and axSpA disease duration as covariates. Incidence rates (IR) were calculated based on the number of cases per pts at risk over 48 weeks. Observed data are reported.

In this open-label study, we found a significant reduction in the AAU flare rate in axSpA pts with a history of recurrent AAU during the first 48 wks of CZP treatment. Pts also experienced significant improvement in axSpA disease activity during CZP treatment.